Detailed Information

NPI Number 1225099880 has the "Individual" type of ownership and has been registered to the following primary business legal
name (which is a provider name or healthcare organization name) — DR. LUIS JESUS MEJIA PEREZ M.D.. Records indicate that the provider gender is "Male".
The enumeration date of this NPI Number is 03/31/2006. NPI Number information was last updated on 10/23/2007.

The provider is physically located (Business Practice Location) at:

716 E MISSION BLVD SUITE D
POMONA, CA
91766-2040, US

DR. LUIS JESUS MEJIA PEREZ M.D. can be reached at his practice location using the following numbers:

A sole proprietor is the sole (the only) owner of a business that is not incorporated; that unincorporated business is a sole proprietorship.

In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business.

There is no difference between a sole proprietorship and a sole proprietor; they are legally a single entity: an individual.

In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI).

As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. (See NPI Final Rule for information about subparts.)

A sole proprietorship may or may not have employees.

Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W-2s. NPPES does not capture a sole proprietorship's EIN.

Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).

Provider Last Name (Legal Name)

PEREZ

The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.

Provider First Name

LUIS

The first name of the provider, if the provider is an individual.

Provider Middle Name

JESUS MEJIA

The middle name of the provider, if the provider is an individual.

Provider Name Prefix Text

DR.

The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.

Provider Credential Text

M.D.

The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Provider First Line Business Mailing Address

716 E MISSION BLVD

The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''.

Provider Second Line Business Mailing Address

SUITE D

The second line mailing address of the provider being identified. This data element may contain the same information as ''Provider second line location address''.

Provider Business Mailing Address City Name

POMONA

The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''.

Provider Business Mailing Address State Name

CA

The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''.

Provider Business Mailing Address Postal Code

91766-2040

The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''.

Provider Business Mailing Address Country Code

US

The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''.

Provider Business Mailing Address Telephone Number

909-865-5777

The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''.

Provider First Line Business Practice Location Address

716 E MISSION BLVD

The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Second Line Business Practice Location Address

SUITE D

The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Business Practice Location Address City Name

POMONA

The city name in the location address of the provider being identified.

Provider Business Practice Location Address State Name

CA

The State or Province name in the location address of the provider being identified.

Provider Business Practice Location Address Postal Code

91766-2040

The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.

Provider Business Practice Location Address Country Code

US

The country code in the location address of the provider being identified.

Provider Business Practice Location Address Telephone Number

909-865-5777

The telephone number associated with the location address of the provider being identified.

Provider Enumeration Date

03/31/2006

The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date

10/23/2007

The date that a record was last updated or changed.

Provider Gender Code

M

The code designating the provider's gender if the provider is a person.

Provider Gender

Male

The provider's gender if the provider is a person.

Healthcare Provider Taxonomy Code #1

207Q00000X

The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.

Healthcare Provider Taxonomy 1

Family Medicine

Healthcare Provider Taxonomy #1

Provider License Number 1

G72538

Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.

Provider License Number State Code 1

CA

Provider License Number State Code #1

Healthcare Provider Primary Taxonomy Switch 1

Y

Primary Taxonomy:

X - The primary taxonomy switch is Not Answered;

Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);